Lusch Achim, Okhunov Zhamshid, del Junco Michael, Yoon Renai, Khanipour Ramtin, Menhadji Ashleigh, Landman Jaime
Department of Urology, University of California, Irvine, Orange, CA.
Department of Urology, University of California, Irvine, Orange, CA.
Urology. 2015 Jan;85(1):268-72. doi: 10.1016/j.urology.2014.09.032.
To evaluate performance characteristics and optics of a novel dual-working channel fiberoptic ureteroscope (Wolf Cobra) with 2 single-channel fiberoptic ureteroscopes and to a single-channel distal sensor standard definition digital ureteroscope URF-V (SD-DS).
Four new ureteroscopes (Cobra, Viper, X(2), and SD-DS) were compared for active deflection, irrigation flow, and optical characteristics. We performed a porcine ureteroscopy and measured the time for cleaning the middle calyx after injection of 10 cc of a standardized bloody solution.
The SD-DS showed a higher resolution (7.42 lines/mm; P = .0001) compared with the fiberoptic ureteroscopes; among the fiberoptic ureteroscopes, the Cobra had the highest resolution than the Viper and X(2) (P = .0001). Grayscale distribution and color representation were identical for the fiberoptic ureteroscopes, whereas the SD-DS provided a superior color representation and a significant higher depth of field. The Cobra provided superior flow with empty working channel (86 cc/min vs 68 cc/min [Viper] vs 62.5 cc/min [X(2)] vs 62 cc/min [SD-DS]; P = .0001) and with various accessories (P <.0001). With regard to deflection, the Storz X(2) and the Cobra provided superior deflection up and down (P <.0001). When evacuating a standardized bloody field, the Cobra provided significant shorter evacuation times compared with those of the Viper, X(2), and SD-DS (36.6 vs 72 vs 65.6 vs 72.6 seconds, respectively; P = .0001).
The additional working channel of the Wolf Cobra may improve vision and performance during challenging ureteroscopic cases by providing an increased flow. The enhanced irrigation capabilities of the Cobra have to be balanced with a larger diameter of this ureteroscope.
将一种新型双工作通道纤维输尿管镜（狼牌眼镜蛇）与2种单通道纤维输尿管镜以及一种单通道远端传感器标准清晰度数字输尿管镜URF-V（SD-DS）的性能特点及光学性能进行评估。
对4种新型输尿管镜（眼镜蛇、蝰蛇、X(2)和SD-DS）的主动偏转、冲洗流量及光学特性进行比较。我们进行了猪输尿管镜检查，并测量了注入10毫升标准化血性溶液后清洁中肾盏所需的时间。
与纤维输尿管镜相比，SD-DS显示出更高的分辨率（7.42线/毫米；P = 0.0001）；在纤维输尿管镜中，眼镜蛇的分辨率高于蝰蛇和X(2)（P = 0.0001）。纤维输尿管镜的灰度分布和色彩呈现相同，而SD-DS提供了更好的色彩呈现和显著更高的景深。眼镜蛇在工作通道为空时（86毫升/分钟，相比之下蝰蛇为68毫升/分钟、X(2)为62.5毫升/分钟、SD-DS为62毫升/分钟；P = 0.0001）以及使用各种附件时（P < 0.0001）提供了更好的冲洗流量。在偏转方面，史托斯X(2)和眼镜蛇在上下偏转方面表现更优（P < 0.0001）。在清除标准化血性视野时，与蝰蛇、X(2)和SD-DS相比，眼镜蛇的清除时间显著更短（分别为36.6秒、72秒、65.6秒和72.6秒；P = 0.0001）。
狼牌眼镜蛇的额外工作通道可通过增加冲洗流量，在具有挑战性的输尿管镜手术中改善视野和性能。眼镜蛇增强的冲洗能力必须与其较大的直径相权衡。
